Presentation
Left proptosis.
Patient Data
There is a well-circumscribed left intra-orbital soft tissue mass of intraconal location between the optic nerve, and the lateral rectus muscle. It appears isodense compared to muscles with intense, and relatively homogeneous enhancement following IV contrast. A mass effect is noted on the optic nerve which is displaced medially with proptosis grade II. No bone lesion was seen on bone window.
The previously described left orbital mass is of intermediate signal on T1WI, inhomogeneous high signal on T2WI/FLAIR with intense, and heterogeneous enhancement on postcontrast sequences.
Bilateral extensive patchy confluent changes in the peri-and juxta-ventricular white matter, as well as deep white matter, of low signal on T1WI, and high signal on T2WI, and FLAIR sequences, most consistent of chronic small vessel ischemia (leukoaraiosis).
The ventricular system is moderately dilated with enlarged cortical sulci.
Case Discussion
MRI features are most consistent of orbital cavernous hemangioma.
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